Aim. To evaluate the 5-year results of renal denervation (RDN) in patients with resistant arterial hypertension (AH). Materials and methods. The study included 14 patients to whom, during the 2011-2013 period RDN has been completed. Before and after the intervention, office blood pressure, quality of life indicators according to the EQ-5D questionnaire, mass index bodies, indicators of kidney function were duly assessed. Results. Five years after RDN, office BP decreased from 165/110 to 139/95 mm Hg. Art. (p

Despite the possibilities of contemporary pharmacotherapy, more than 80% of hypertensive patients do not achieve target blood pressure levels. Besides the obvious reasons – poor adherence of patients to treatment and non-rational therapy, there are other objective risk factors of resistance. Three main modifiable causes of resistant hypertension, that are often underestimated, are considered: obesity, obstructive sleep apnea syndrome and primary hyperaldosteronism. Understanding these mechanisms of resistance and their diagnostic criteria can improve the results of resistant hypertension treatment.

Aim. To study the effect of renal denervation on blood pressure (BP), myocardium function and vegetative status in patients with resistant hypertension (HT).Material and methods. Patients with a provisional resistant HT diagnosis (n=62; 41.3% male) were included into the study. 17 patients were selected for renal denervation after correction of previous antihypertensive therapy and examination to exclude symptomatic HT. Two patients refused the procedure, 1 patient hadn't undergone renal denervation due to anatomical features (renal artery diameter < 4 mm). Renal denervation was performed in 14 patients. Office and average daily BP, kidney function, the severity of left ventricular hypertrophy and heart rate variability were assessed initially and after the intervention.Results. Office systolic BP (SBP) decreased from 165 to 150 mm Hg (p=0.016), diastolic BP (DBP) -from 110 to 95 mm Hg (p=0.019) 12 months after the renal denervation. Average daily SBP decreased from 148 to 137 mm Hg (p=0.092), average daily DBP -from 90 to 80 mm Hg (p=0.401). Plasma creatinine level and glomerular filtration rate remained within the reference range at a baseline and in 12 months. Left ventricular hypertrophy measured by echocardiography has not changed significantly. No significant heart rate variability dynamics has been found.Conclusion. Renal denervation is a promising treatment for resistant HT. The effect of renal denervation on the dynamics of left ventricular hypertrophy and heart rate variability requires updating.

A new method of non-drug treatment of resistant hypertension – renal denervation is considered. General information about resistant hypertension, method of renal denervation, the results of clinical studies on efficacy and safety, as well as own clinical case are presented.

Aim. To study the effect of renal denervation on blood pressure (BP), myocardium function and vegetative status in patients with resistant hypertension (HT). Material and methods. Patients with a provisional resistant HT diagnosis (n=62; 41.3% male) were included into the study. 17 patients were selected for renal denervation after correction of previous antihypertensive therapy and examination to exclude symptomatic HT. Two patients refused the procedure, 1 patient hadn’t undergone renal denervation due to anatomical features (renal artery diameter <4 mm). Renal denervation was performed in 14 patients. Office and average daily BP, kidney function, the severity of left ventricular hypertrophy and heart rate variability were assessed initially and after the intervention. Results. Office systolic BP (SBP) decreased from 165 to 150 mm Hg (p=0.016), diastolic BP (DBP) - from 110 to 95 mm Hg (p=0.019) 12 months after the renal denervation. Average daily SBP decreased from 148 to 137 mm Hg (p=0.092), average daily DBP - from 90 to 80 mm Hg (p=0.401). Plasma creatinine level and glomerular filtration rate remained within the reference range at a baseline and in 12 months. Left ventricular hypertrophy measured by echocardiography has not changed significantly. No significant heart rate variability dynamics has been found. Conclusion. Renal denervation is a promising treatment for resistant HT. The effect of renal denervation on the dynamics of left ventricular hypertrophy and heart rate variability requires updating.

Renal denervation is a novel promising approach for resistant hypertension management and it is getting more widespread. In recent years, this procedure has been studied not only as a method of additional reduction of blood pressure in non-responders to standard antihypertensive therapy, but also as a way of influencing other syndromes and diseases, which are related to sympathetic hyperactivity. The article provides a review of clinical trials of renal denervation in patients with insulin resistance and diabetes mellitus, left ventricular hypertrophy, heart failure, obstructive sleep apnea syndrome, atrial fibrillation and chronic kidney disease. Despite the controversial results of studies of renal denervation in patients with hypertension, there are more clinical data on the positive effect of the procedure on carbohydrate metabolism, left ventricular hypertrophy reduction and ejection fraction. The results of studies of renal denervation in patients with obstructive sleep apnea syndrome, as well as in patients with paroxysmal atrial fibrillation, are very interesting, though limited. There are more data on the safety of renal denervation in patients with chronic kidney disease. There are a lot of ongoing trials of renal denervation in different cohorts.

Renal denervation is a novel promising approach for resistant hypertension management and it is getting more widespread. In recent years, this procedure has been studied not only as a method of additional reduction of blood pressure in non-responders to standard antihypertensive therapy, but also as a way of influencing other syndromes and diseases, which are related to sympathetic hyperactivity. The article provides a review of clinical trials of renal denervation in patients with insulin resistance and diabetes mellitus, left ventricular hypertrophy, heart failure, obstructive sleep apnea syndrome, atrial fibrillation and chronic kidney disease. Despite the controversial results of studies of renal denervation in patients with hypertension, there are more clinical data on the positive effect of the procedure on carbohydrate metabolism, left ventricular hypertrophy reduction and ejection fraction. The results of studies of renal denervation in patients with obstructive sleep apnea syndrome, as well as in patients with paroxysmal atrial fibrillation, are very interesting, though limited. There are more data on the safety of renal denervation in patients with chronic kidney disease. There are a lot of ongoing trials of renal denervation in different cohorts.